HIV prevention in the world of work in sub-Saharan Africa: research and practice

Unlike some diseases that affect the vulnerable (such as children), HIV primarily affects those most productive in the population. Within this context the private sector has a considerable role to play in managing HIV and AIDS and in contributing to comprehensive national responses. As the HIV epidemic expanded in sub-Saharan Africa, it threatened to weaken an already fragile skills base in many countries, placing pressure on worker recruitment and replacement costs, aggravating absenteeism, and contributing to the direct and indirect costs of production and performance (International Finance Corporation, 2002; Ellis & Terwin, 2005; Global Business Coalition on HIV/AIDS & Booz Allen Hamilton, 2006). In South Africa, amid debate over the motivations of company responses to the HIV epidemic and in a context of inaction and denial by the government, large firms took the lead in the provision of antiretroviral therapy (ART) to all employees with HIV who qualified for treatment; they did so well before the South African public health sector made the treatment available in 2004 (Dickinson, 2004). Debswana Diamond Company (De Beers’s operation in Botswana) led this initiative in 2001, followed by Anglo American in 2002 (The Economist, 2002; Van der Walt, 2007). Since then, many corporate firms on the continent have developed well-established programmatic responses to HIV and AIDS (Family Health International, 2002; Dickinson, 2009). National business coalitions have also played a major role in responding to HIV epidemics in sub-Saharan Africa by facilitating the development of workplace policies and programmes, establishing public–private and community partnerships, and generating dialogue between sectors, with businesses providing in-kind contributions and donations (UNAIDS, 2011a). Against this backdrop, company efforts to address HIV in the workplace have been at the forefront of the global response (Sprague & Dickinson, 2008). The need to document and replicate successful HIV/AIDS responses has been repeatedly stressed by all stakeholders. Indeed, national strategic plans in African countries prioritise the dissemination of a growing body of experience and innovation in HIV-related care, treatment and support strategies, across public, private and non-profit sectors (see Government of Botswana, 2003; Government of Lesotho, 2007; Government of South Africa, 2007; Government of Uganda, 2007). While a range of HIV/AIDS-related activities takes place in the world of work in African countries every day, gaps in our knowledge remain. Since 2004, African researchers have come together to create a platform for high-quality applied research on HIV in the workplace, among academics, business people and other interested partners. The aim has been to build on and formalise the network of researchers, particularly new and younger researchers; to signal the importance of supporting university-based research on HIV in the world of work; to conduct quality, evidence-based research on this topic; to inform workplace policies and practices; and, to disseminate the findings of research among other researchers and decision-makers responsible for addressing HIV and AIDS in their organisations. To this end, the South